Will plastic surgeons – and their patients – be footing the bill for major health care reform? Henry Stern at Insureblog discovers another case of “cranial-rectal inversion” as he reflects on the proposed taxing of non-essential procedures to finance “deficit neutral” health care reform, aka: the Nip/Tuck/Tax.

Evan Falchuk from See First notes that trying to adjust health benefits in the private sector is a sensitive subject, so it isn’t surprising that the President is taking a hit for his attempts at reform. Perspective provided at Don’t Mess With My Healthcare.

Barbara at Florence dot com is riled and she takes on health care reform (with a nod to our Canadian neighbors) in Truth, Like Rain, Does Not Care Who Gets Wet and it’s worth reading for this alone “…advertisements portray middle aged men who can’t pee as the next generation of Outward Bound campers”. But read it context; it’s even better!

I have to let DrRich of The Covert Rationing Blog introduce this post himself: “I have long been one of those unenlightened physicians who thought alternative medicine was evil, but now I’ve seen the truth – ‘medical woo’ is our road to salvation.” So, find out Why DrRich Supports Medical Woo. It’s….so…logical!

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Looks like Wallace and Gromit are more than a little concerned about finding the evil penguin Feathers McGraw on their platter!

Speaking of reflexes, Reality Rounds asks that rhetorical question, Did I Just Pee? And yes, she actually did! Find out why and what she has discovered about perineal integrity along the way! Ladies, listen up!

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When they aren’t busy inventing, our hosts Wallace and Gromit enjoy the fun of a seaside roller coaster ride!

Maybe they are thinking about the medblogger track at BlogWorld/New Media Expo 09, being held in Las Vegas in October? Information on registration can be found here and rooms are available at the Venetian at a discount! Be there or be totally square!

And that ends this edition of Grand Rounds. Many thanks to Dr. Val Jones at Better Health and Colin Son for keeping the carnival up and running and to Nick Genes for starting it all way back when!

[…] medical blogging, and one of the best ways to get reconnected with great medical writers is through Grand Rounds, hosted this week by Kim of Emergiblog. Â It’s also her 4 year blogging anniversary, and she’s brought together a wealth of […]

Hi Kim,
In support of all the people struggling with mental illness, and in particular, MDD, I just have to respond to the Philip Hicky article, “Behaviorism & Mental Health: “depression is not an illness”. My response is long and wordy, but I fear Mr H will not post this resonse to him on his website, and I worry people with MDD might end up there and think their illness is their fault. That is how I felt reading his piece.

Here goes:

in response to Philip Hickey’s “depression is not an illness:

For me severe depression really did just pop out of nowhere. There was nothing wrong with my life during these episodes…I had a great life. It was the depression that stopped me in my tracks, not the other way around.

When you wrote, “When things are going well in our lives, we feel good”…I understood immediately that you misunderstand MDD. The sad thing about MDD is that even if things are going well this illness destroys a person’s ability toi feel good.

I find it difficult to understand how you treat people with depression when you place so much distance and dogma between yourself and your patients. When you say,

“Many of these individuals lived on a diet of soda pop [I can count on my hands the numer of sodas I have drank in the last 5 years], cigarettes[don’t smoke], and salami sandwiches[I think the last salami sandwich I ate was in high school…I’m 44]. Others drank enormous quantities of alcohol [I used to drink periodically…like many other happy people I know…until I got as severely depressed as I am now. In which case it drove me to drink more to try to help my symptoms]. Few ate vegetables regularly[ was vegetarian.so did well here]. Many stayed indoors almost all the time [see my above list of favourite and common activities]. Physical activity was almost always minimal [ditto]. Purposeful activity – i.e. activity directed towards some kind of goal – was seldom present [university? , and good honest, open relationships almost non-existent…[great frienships?]…

…Chronically depressed people, however,are individuals who have been neglecting these areas for years. They spend the vast majority of their lives indoors, watching television and eating snack food. They are often over-weight, have no goals other than the next TV show, and although they may have many acquaintances, they do not share their concerns and worries in an open and honest manner”

…it struck me that you believe very strongly that “we”are so very different from you. We just don’t try hard enough to be happy. If only “we” would try harder, “we” could be as happy as “you”.

Have you ever really worked with someone with clinical depression? Contrary to your statement that we are indoorsy, crappy food eating, inactive, solitary, lazy, unfocused, fat, slobs.. [actually slob is my word…it’s how i sense we seem to you) people with MDD are a wide range of people…some of us even active, outdoorsy, friendly and friend supporting, anti-t.v., fit and interested and interesting people.

It becomes clear you have never understood what it is to be depressed when you state, “Depression or despondency is not as acute a sensation as pain”. In the past I broke both my elbows at the same time, had a severe case of CMV related hepatitis that required hospitalization, have broken my leg, my ankle, my wrist, had three concussions, was injured in a car accident, had a doctor drill into my leg bone for bone marrow, basically have suffered a lot of physical pain.

NOTHING is as painful as severe and chronic MDD. When I broke my elbows I had just come out of the hospital after having ECT. For the first time in years I felt mentally well. I REFUSED any pain medication for my physical pain, for fear that my psychic pain would recur. NOTHING hurts like mental pain…NOTHING.

Aqua, I felt the same way when I read his post, and honestly I was a little surprised that he was included in the Grand Rounds. I mean, on the one hand there are interesting questions around the neurochemistry of depression; the old serotonin hypothesis doesn’t seem to work and yet antidepressants do seem to help people. All sorts of good research to be done there. But going off about how depression is just a sign that you need to get your $h!t together already? Really?

A quick note from the hostess here: when I host Grand Rounds, it is extremely rare that I exclude a submission. I will disagree, from time to time, with the opinion of a blogger, but I put it out there and let the discussion take off.

Each Grand Rounds host does things a bit differently; you will find hosts that are all-inclusive and those who edit the submissions via content. I’m 99.9% inclusive – I’m not really a fan of flat out sales pitch sites.

And, for the record, I firmly believe you can have all your, uh, $hit together and still suffer from depression – been there, done that! : )

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...